Predictors of outcome in fulminant hepatic failure in children.
Artículo
en Inglés
| IMSEAR
| ID: sea-64212
ABSTRACT
OBJECTIVE:
To identify the predictors of outcome in fulminant hepatic failure (FHF) in children. STUDYDESIGN:
Prospective cohort study.METHODS:
41 children with FHF were studied. Patient characteristics and findings on examination at the time of hospitalization were noted. Serum biochemistry and screening for hepatotropic viruses (A, B and C) were done in each patient. Patients were treated using a predefined protocol and followed up till death or discharge. Univariate and multivariate analysis was done to find the predictors of outcome.RESULTS:
Hepatitis B was the commonest cause of FHF (11 children; 26.9%). Markers for hepatitis A and C viruses were present in one and two patients, respectively. Serology was negative in 27 children (65.9%), of whom two had history of ingestion of hepatotoxins (antitubercular drugs). The overall mortality was 61%. Irrespective of etiology, the following factors were associated with poor outcome on univariateanalysis:
presence of gastrointestinal (GI) hemorrhage, serum bilirubin more than 10 mg/dL, age 6 years or less, coma of grade 3 or more, presence of infection, prolongation of prothrombin time > 8 s over control, prothrombin concentration < 50%, hypoglycemia (blood glucose < 45 mg/dL), hyponatremia (serum sodium < 125 mEq/L) and hyperkalemia (serum potassium > 5.5 mEq/L). On multiple logistic regression analysis, presence of GI hemorrhage (p = 0.005), degree of coma (p = 0.02) and serum bilirubin level (p = 0.025) were identified as independent predictors of mortality.
Texto completo:
Disponible
Índice:
IMSEAR (Asia Sudoriental)
Asunto principal:
Pronóstico
/
Femenino
/
Humanos
/
Masculino
/
Modelos Logísticos
/
Niño
/
Preescolar
/
Encefalopatía Hepática
/
Tasa de Supervivencia
/
Estudios Prospectivos
Tipo de estudio:
Estudio de etiología
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
País/Región como asunto:
Asia
Idioma:
Inglés
Año:
1998
Tipo del documento:
Artículo
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